title: Combined clear cornea phacoemulsification in the treatment of pseudoexfoliative glaucoma associated with cataract: significance of trabecular aspiration and ab interno trabeculectomy.
abstract: BACKGROUND
  In the present study, the effectiveness of combined cataract surgery and ab interno trabeculectomy (Trabectome) in exfoliation glaucoma (PEX) was compared with combined cataract surgery and trabecular aspiration.
  
  
  METHODS
  In this retrospective comparative cohort outcome study, 27 consecutive patients (mean age 73.41 years ± 10.78) in group 1 suffering from visually significant cataract and PEX glaucoma (mean preoperative IOP 23.41 mmHg ± 5.86) were treated with phacoemulsification combined with Trabectome; and 28 consecutive patients (73.83 years ± 8.94) were treated with phacoemulsification combined with trabecular aspiration (mean preoperative IOP 22.22 mmHg ± 6.33). The intraocular pressure (IOP) and the number of antiglaucoma eyedrops before and after surgery were evaluated.
  
  
  RESULTS
  Examinations were performed prior to surgery, 1 day, 6 weeks, 3 months, 6 months, and 1 year after surgery. In both groups there was a statistically significant decrease in postoperative IOP during the whole follow-up period. Comparing the two groups, there was a statistically significant lower IOP in the Trabectome group 1 day (p = 0.019), 6 months (p = 0.025), and 1 year (p = 0.019) after surgery. Between the two groups, there was no statistically significant difference in the number of antiglaucoma eyedrops at any time.
  
  
  CONCLUSIONS
  Both procedures have the ability to significantly lower the postoperative IOP during the first year. However, clear cornea phacoemulsification combined with Trabectome seems to be more effective in IOP reduction in cases of PEX glaucoma associated with cataract.
authors.affiliation: Department of Ophthalmology, Charité, University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany, matthias@klamann.net.
authors.forename: Matthias K J
authors.initials: MK
authors.lastname: Klamann
authors.forename: Johannes
authors.initials: J
authors.lastname: Gonnermann
authors.forename: Anna-Karina B
authors.initials: AK
authors.lastname: Maier
authors.forename: Peter C
authors.initials: PC
authors.lastname: Ruokonen
authors.forename: Necip
authors.initials: N
authors.lastname: Torun
authors.forename: Antonia M
authors.initials: AM
authors.lastname: Joussen
authors.forename: Eckart
authors.initials: E
authors.lastname: Bertelmann
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D002386:Cataract / Q000150:complications / Q000628:therapy*; D003315:Cornea / Q000601:surgery*; D017889:Exfoliation Syndrome / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000379:methods*; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents